• Facilitating students towards self-directed learning

      Regan, Julie-Anne (Routledge, 2005-03-17)
      This chapter discusses a study which focused on students' perspectives of self-directed learning. The study was structured around 5 questions - what do students understand by the term self-directed learning, how effective do students feel self-directed learning is, what support do students percieve as necessary for effective self-directed learning, what do students feel are the barriers to self-directed learning, and what motivates students towards self-directed learning.
    • Factors affecting mental health support to the British Armed Forces: Part One

      Finnegan, Alan; Finnegan, Sara; Thomas, Mike; University of Chester (Ptm Publishers Limited, 2014-11)
      To help the British armed forces minimise mental health problems while undertaking military duties, operational psychological support is provided by military mental health nurses. This series of two articles is part of the first qualitative research completed in Afghanistan by British armed forces into the effectiveness of the military mental health nursing role. The authors aim to increase understanding of the factors that affect the delivery of nursing care during an operational deployment, including educational and clinical competency, multiprofessional and multinational boundaries, and the challenges of providing nursing care for both military personnel and local nationals. This article, the first of the two-part series, looks at the set up of the study, while the second article (featured in the next issue of JCN) will look at the study findings
    • Factors affecting mental health support to the British armed forces: part two

      Finnegan, Alan; Finnegan, Sara; Thomas, Mike; University of Chester (Ptm Publishers Limited, 2015-01)
      The first part of this series (JCN, 28(5): 30–32) provided the background to the study, which used semi-structured interviews with 18 nurses based in Afghanistan during 2013 to focus on factors affecting the delivery of mental health care in the field. This, the second part of the series, details the results of the study in the form of analysis of the interviewees’ verbatim transcripts. The study offers an insight into the role of deployed mental health nurses and examines some of the challenges they face. The findings demonstrate that managing the mental health of armed forces personnel on an operational deployment requires the ability to develop trusting relationships, identify factors leading to stress, and help staff to feel supported.
    • Factors influencing the effectiveness of clinical supervision

      Edwards, David R.; Cooper, Linda; Burnard, Philip; Hannigan, Ben; Adams, John; Fothergill, Anne; Coyle, David L.; University of Wales College of Medicine; University of Galmorgan; University College Chester (Wiley, 2005-08-01)
      This article reports findings from a study that aims to identify the factors that may influence the effectiveness of clinical supervision for community mental health nurses (CMHNs) in Wales.
    • Falling mortality rates in Type 2 diabetes mellitus in the Wirral Peninsula: a longitudinal and retrospective cohort population-based study

      Nwaneri, Chukwuemeka; Bowen-Jones, David; Cooper, Helen; Chikkaveerappa, Krishnamurthy; Afolabi, Banjo A.; University of Chester ; Wirral University Teaching Hospital Foundation NHS Trust ; University of Chester ; Wirral University Teaching Hospital Foundation NHS Trust ; Aintree University Hospitals NHS Foundation Trust (BMJ journals, 2012-08-17)
      Objectives To determine the life expectancy and mortality rates in patients with type 2 diabetes mellitus when compared with the UK general population; to measure the years of life lost. Design Longitudinal and retrospective cohort study. Setting The Wirral Peninsula in the northwest of England. Participants Total of 13 620 patients with type 2 diabetes mellitus on the Wirral Diabetes Register. Main Outcome measure All-cause mortality, from 1 January 2000 to 31 December 2007. Over the 8-year period of the study, there were a total of 16 692.5 person-years lived and 3888 deaths; 2041 (52.5%) males and 1847 (47.5%) females with corresponding mean ages at death of 75.6610.3 years and 80.2610.2 years, respectively. Although prevalence rates increased linearly (from 1.06% in 2000 to 4.39% in 2007) a decrease in mortality rates (from 117 to 46 per 1000 population) in both sexes was observed. This coincided with a progressive fall in cardiovascular risk factors in this population. A survival time curve of life lived until death showed that males had 8.0 years reduction in life span and females’ life span was reduced by 9.6 years when compared with UK general population. In both sexes, life expectancy was reduced by between 2 and 11 years dependent on the age of diagnosis, with males showing a greater degree of reduction. Conclusion Type 2 diabetes mellitus is associated with a significant reduction in life expectancy, more markedly in men, and in those diagnosed before age 70 years. However, annual mortality rates have fallen progressively in our population and may contribute to longer survival and life expectancy in future years.
    • Feedback

      Cooke, Irene; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses feedback as a vitial component of teaching and learning and how it contributes to lifelong learning and professional development.
    • Feedback and marking

      McIntosh, Annette; University of Chester (SAGE, 2010-10-29)
      This book chapter discusses how the provision of quality feedback is central to the progress and development of students and the iportnace of ensuring the quality of marking assessments.
    • Feeling Healthy? A Survey of Physical and Psychological Wellbeing of Students from Seven Universities in the UK

      El Ansari, Walid; Stock, Christiane; Snelgrove, Sherrill; Hu, Xiaoling; Parke, Sian; Davies, Shân; John, Jill; Adetunji, Hamed; Stoate, Mary; Deeny, Pat; et al. (MDPI, 2011-04-27)
      Abstract: University students’ physical and psychological health and wellbeing are important and comprise many variables. This study assessed perceived health status in addition to a range of physical and psychological wellbeing indicators of 3,706 undergraduate students from seven universities in England, Wales and Northern Ireland. We compared differences in these variables between males and females, and across the participating universities. The data was collected in 2007–2008. A self-administered questionnaire assessed socio-demographic information (e.g., gender, age), self-reported physical and psychological health data, as well as questions on health awareness, health service use, social support, burdens and stressors and university study related questions. While females generally reported more health problems and psychological burdens, male students felt that they received/had fewer persons to depend on for social support. The comparisons of health and wellbeing variables across the different universities suggested some evidence of ‘clustering’ of the variables under study, whereby favourable situations would be exhibited by a cluster of the variables that is encountered at some universities; and conversely, the clustering of less favourable variables as exhibited at other universities. We conclude that the level of health complaints and psychological problems/burdens is relatively high and calls for increased awareness of university administrators, leaders and policy makers to the health and well-being needs of their students. The observed clustering effects also indicate the need for local (university-specific) health and wellbeing profiles as basis and guidance for relevant health promotion programmes at universities.
    • Feme pad: Out of the ice age and into the new millennium

      Steen, Mary; Leeds Teaching Hospitals NHS Trust (Mark Allen Publishing, 2000-05-03)
      Explains the principles behind and use of the Feme Pad, a new cooling gel pad designed to alleviate perineal pain and reduce swelling following delivery.
    • Fieldwork and the practical implications for completing qualitative research in the British Armed Forces

      Finnegan, Alan; University of Chester (British Medical Journal, 2014-01-09)
      This article provides direction regarding the practical implications of undertaking qualitative research within the British Army, and in particular the Defence Medical Services (DMS). Qualitative researchers must gather sufficient data to answer their research question, and guidance on using DMS healthcare professionals as the research sample is offered, including dealing with the 'gatekeepers' who control access, and the principles for creating a conducive environment to gather reliable data. Data collection is often through intensive interviewing where communication skills and personal awareness are vital to a successful study. Aids to a productive study include memo writing and listing factors that may later provide an insight into how the interviewees characterise and describe particular activities, events and groups. Guidance is offered to develop an interview schedule with questions related to each other in a seamless, meaningful way. Both the researcher's and participant's conscious and unconscious biases must be acknowledged. In this narrow and specialist field, DMS researchers need extensive knowledge of clinical practice and the military's distinctive language, characterised with nuances and abbreviations. These words portray meanings and perspectives that signpost the participants' view of their empirical world. Early identification, without having to seek clarification, means that the researcher can examine hidden assumptions in the sample's own language
    • Financial aspects for patients and carers

      Woodhouse, Jan; University of Chester (SAGE, 2010-10-15)
      This book chapter discusses the financial burden that an illness may bring and how health care practitioners can help.
    • Finding the Forgotten: Motivating Military Veterans to Register with a Primary Healthcare Practice

      Finnegan, Alan; Jackson, Robin; Simpson, Robin; University of Chester; NHS Bury Clinical Commissioning Group; Ministry of Defence Deanery (Oxford University Press, 2018-05-09)
      Introduction: In the UK, primary healthcare practices choose from a series of Read codes to detail certain characteristics onto a patient's medical documentation. One of these codes is for military veterans indicating a history relating to military service. However, veterans are poor at seeking help, with research indicating that this code is only applied in 7.9% of cases. Clinical staff have a clear role in motivating veterans to declare their ex-Forces status or register with a primary healthcare center. The aim of this study was to motivate veterans to notify primary healthcare staff of their armed forces status or register with a general practitioner, and to improve primary healthcare staff's understanding of veterans' health and social care issues. Materials and Methods: Data were provided by four primary healthcare centers' containing 40,470 patients in Lancashire, England during 2017. Pre- and post-patient medical record Read Code searches were conducted either side of a 6-wk intervention period centered on an advertising campaign. The data identified those veterans with the military specific Read code attached to their medical record and their age, gender, marital status and mental health disorders. Further information was gathered from interviews with eight members of staff, some of whom had completed an e-learning veteran healthcare academic module. The study was approved by the University of Chester's Research Ethics Committee. Results: The pre-intervention search indicated that 8.7% (N = 180) of veterans were registered and had the correct military specific code applied to their medical record. Post-intervention, this figure increased by nearly 200% to N = 537. Mental health disorders were present in 28% (N = 152) of cases, including 15% (N = 78) with depression. Interviews revealed the primary healthcare staff's interpretation of the factors that motivated patients to declare their ex-Forces status and the key areas for development. Conclusion: The primary healthcare staff took ownership and responsibility for this initiative. They were creative in introducing new ways of engaging with the local armed forces community. Many veterans' and staff were unaware of veterans' entitlement to priority medical services, or the wider provisions available to them. It is probable that veterans declaring their military status within primary healthcare, or registering with a general practitioner for the first time is likely to increase. Another review will be undertaken after 12 mo, which will provide a better indication of success. There remains however an ongoing need to reach out to those veterans who never access a primary healthcare practice. This paper adds to the limited international empirical evidence undertaken to explore help-seeking behavior in an armed forces community. The positive outcomes of increased awareness and staff commitment provide a template for improvement across the UK, and will potentially stimulate similar initiatives with international colleagues.
    • First Pass Metabolism

      Robertson, Deborah A. F.; University of Chester (Mark Allen Healthcare Ltd, 2017-06-08)
      In this article in the series of ‘bite sized’ pharmacology, we will look at the concept of first pass metabolism. All drugs given by the oral route undergo a degree of first pass metabolism either in the gut or the liver, with some drugs being destroyed before they reach the systemic circulation. This pharmacokinetic process affects the bioavailability of drugs administered by this route and is an important consideration for the prescriber. Knowledge of first pass metabolism can assist the prescriber when deciding on doses and dose schedules to ensure that patients receive their medications at the correct dosing, by the correct route for optimum therapeutic effect. It also helps the prescriber understand why dose adjustments are made for some drugs when switching the route of administration from oral and why some drugs cannot be given by the oral route.
    • Food supplementation among HIV-infected adults in Sub-Saharan Africa: Impact on treatment adherence and weight gain

      Audain, Keiron A.; Zotor, Francis B.; Amuna, Paul; Ellahi, Basma; University of KwaZulu Natal ; University of Health and Allied Sciences, Ghana ; University of Greenwich ; University of Chester (The Nutrition Society, 2015-03-12)
      Sub-Saharan Africa has the highest proportion of undernourished people in the world, along with the highest number of people living with HIV and AIDS. Thus, as a result of high levels of food insecurity many HIV patients are also undernourished. The synergism between HIV and undernutrition leads to poor treatment adherence and high mortality rates. Undernutrition has a debilitating effect on the immune system due to key nutrient deficiencies and the overproduction of reactive species (oxidative stress), which causes rapid HIV progression and the onset of AIDS. Therapeutic food supplementation used in the treatment of severe acute malnutrition is being applied to HIV palliative care; however, little biochemical data exist to highlight its impact on oxidative stress and immune recovery.
    • Forensic nurses' perceptions of labels of mental illness and personality disorder: Clinical versus management issues

      Mason, Tom; Hall, Rebecca; Caulfield, Mike; Melling, Katherine; University of Chester (Blackwell, 2010-02-09)
      Anecdotally, forensic psychiatric nurses generally have a more negative perception of people diagnosed with a personality disorder and this negativity is focused more towards managing the behaviours rather than on treatment efficacy and clincal outcomes. this study reports on research carried out across the High, Medium and Low secure psychiatric services in the UK. One thousand two hundred questionnaires were distributed with a response rate of 34.6%. The results indicated a statistically significant differences across High (z=9.69; P< 0.01), Medium (z=11.06; P< 0.01) and Low (z= 9.57; P=0.01) security with a focus on the management of people with a personality disorder using the Wilcoxon paired samples test. There was also a statistically significant difference in relation to a more clinical/treatment focus for those with a diagnosis of mental illness in Medium (z= 9.69; P=0.01) and Low (z= 9.57; P<0.01) security but not in the High security services. Finally, the results showed significant differences between High, Medium and Low security on each of the four scales of Personality Disorder Clinical - Personality Disorder Management and Mental Illness Clinical - Mental Illness Management. This raises issues of stigma, prejudice and discrimination and suggests a refocus on skills development, acquisition and application for those with a label of personality disorder.
    • Forensic psychiatric nursing: Skills and competencies: I role dimensions

      Mason, Tom; Lovell, Andy; Coyle, David L.; University of Chester (Blackwell, 2008-01-18)
      This paper reports on an investigation into the skills and competencies of forensic psychiatric nurses from the perspective of three groups (a) forensic psychiatric nurses, (b) non-forensic psychiatric nurses and (c) other disciplines. A national survey of freonsc psychiatric services in the UK was conducted, and information gathered on the perceived skills and competencies in this growing field of psychiatric practice. From 3360 questionnaires, 1172 were returned making a response rate of 35%. The results indicate a small discrepancy between forensic nurses' and non-forensic nurses' perceptions of the role constructs of forensic practice. However, a larger difference was noted between nurses'perceptions and other disciplines' perceptions of the constituent parts to forensic psychiatric nursing. Nurses tend ed to focus on personal qualities both in relation to themselves and th epatients, while the other disciplines focused on organizational structures both in defining the role and in the resolution of perceived deficits. The findings have implications for multidisciplinary working, as well as policy formulation and curriculum development in terms of the skills and competencices of forensic nurse training.
    • Forensic psychiatric nursing: Skills and competencies: II Clinical Aspects

      Mason, Tom; Coyle, David L.; Lovell, Andy; University of Chester (Blackwell, 2008-01-18)
      This study reports on research undertaken to identify the skills and competencies of forensic psychiatric nurses working in secure psychiatric services in the UK. The rationale for this research is the lack of clarity in the role definition of nurses working in these environments and the specific content that may underscore the curriculum for training forensic nurses. Over 3300 questionnaires were distributed to forensic psychiatric nurses, non-forensic psychiatric nurses and other disciplines and information obtained on (1) the perceived clinical problems that give forensic nurses the most difficulty, (20 the skills best suited to overcome those problems and (3) the priority aspects of clinical nursing care that needs to be developed. A 35% response rate was obtained with 1019 forensic psychiatric nurses, 110 non-forensic psychiatric nurses and 43 other disciplines. The results highlighted a 'top-ten' list of main problems with possible solutions and main areas for development. the conclusions drawn include a focus on skills and competencies regarding the management of personality disorders and the management of violence and aggression.
    • Forensic psychiatry: Influences of evil

      Mason, Tom; University of Chester (Humana Press, 2005-12-15)
      Many conscientious mental health professionals caring for disturbed patients have either unscientifically formulated for themselves notions of 'evil' to explain the behavior of their patients, or have been given patients described by judges and the press as 'evil'. Although such notions may be deemed unscientific, beyond the purview of medicine, and better suited for discussion by theologians and moral philosophers, the fact remains that these notions of 'evil' have a definite impact on the practice of psychiatry, if not all medical fields.
    • Forensic services

      Lovell, Andy; University of Chester (SAGE, 2010-02-15)
      This book chapter offers an overview of the changing context of forensic learning disability services and a discussion of the relationship between learning disability and crime.
    • Foster care matters

      Harlow, Elizabeth; University of Chester (Whiting & Birch, 2011-08-05)